Engaging Fellows: Kevin Fong

The Wellcome Trust’s first ever Engagement Fellows came into the Trust a couple of weeks ago to record a conversation about their different experiences in engaging the public with medicine and its history.

First, Dr Richard Barnett interviewed Dr Kevin Fong – consultant anaesthetist at University College Hospital and television science documentary presenter – about his career from UCL medical school to Engagement Fellow via NASA.

RB: Well, what we share is University College London (UCL) Medical School. So what was the story that got you to medical school?

KF: Slightly convoluted. I didn’t really know what I wanted to do when I was at Sixth Form College but I was good at maths and I was okay at physics and the UCCA handbook, as it was then, was alphabetically arranged and so Astrophysics came up very quickly. And I went to UCL and then I started hanging out with medical students and I thought, “Gosh, I think I might like to do that.” I didn’t think I was working any less hard than they were – physics was quite a tough course – and I realised very rapidly that my skill set was suited to that: you have to be able to take exams, you have to be able to talk to people and you’ve got to want to do it most of all. And so I went to medical school.

RB: But you said you did astrophysics first: how did that shape your outlook on and interest in medicine?

KF: I really am pleased that I had the time to study a properly esoteric subject, sit there and rub your chin about the age of the universe and exotic active galactic nuclei and high-energy astrophysics. I actually took a course called high-energy astrophysics…

RB: Were you just dancing all the time?

KF: Yeah exactly, it was aerobics and –

RB: Techno sort of thing.

KF: Aerobics while you did differential equations, yeah. But towards the end, I thought there must be some practicality to all this, so I looked at medical physics but I realised it was the medicine and not the physics.

A mile wide and an inch deep

RB: What was it that really gripped you about medicine? What excited you and made you want to get up in the morning and go to these awful nine o’clock lectures and ten o’clock dissecting sessions and so on?

KF: For people who love science and the breadth of science, medicine’s quite good because the syllabus is a mile wide and an inch deep, and you see an awful lot of things and you get to see the practical applications in what is generally a very positive way. So I did love it – most people hate the first two years and actually I quite enjoyed them because I was looking down microscopes and seeing things and remembering bits of biology and physiology and anatomy that I hadn’t done for six, seven years.

I did genuinely think that that was it, no more astrophysics. I was headed for general practice because I quite liked the idea of the holistic cradle to grave – when that’s what general practice was. I remember doing my general practice rotation in this little village outside Taunton and thinking, “This is quite a nice existence and you’re part of this community.” But it was by chance that I got to go to NASA in the final year of medical school –

RB: Now that’s a sentence which I get the feeling covers a fascinating story….

KF: We ran out of money: I was paying for the second degree, my parents didn’t have a lot of cash and I started writing to everybody who I thought might have spare cash. And NASA, I thought: well, I’ve got a degree in astrophysics, I’m going to have one in medicine, I’m sure they must have some sort of bursary, surely. And I wrote a lot of emails and letters and eventually one of those hit someone’s desk, I’m not even sure which one, and they sent me this thing: “We have no money but there’s this elective programme that we don’t usually let foreigners come on but apply for that.” I applied and I didn’t think I had a hope in hell: there were four places worldwide and mostly they were taken up by Americans. Then one day this envelope came through with a NASA ‘meatball’ saying “Come, turn up on this date, Johnson’s Space Centre.”

The NASA 'meatball' logo

RB: What were your feelings when that arrived?

KF: That’s right up there in the proper ‘all your Christmases’. They’re very distinct those envelopes from NASA: they’ve got the American Government typeface with the US Government postage stamp on it and the meatball – and the “Please turn up to Johnson’s Space Center, Astronaut training ground”, the place that you’ve always dreamed of going since you were about five years old: that was amazing.

RB: What did you think you would do on this programme?

KF: I had absolutely no idea. I didn’t know what it would lead to and in fact it was just a month of total exposure to the full depth and breadth of NASA’s human space flight operations. It was basically like going to Disneyworld for adults and getting to go on all the rides every day for free. We met astronauts, we got inside simulators, we got to fly in the vomit comet, but we did a bit of research – research in a very NASA sort of way, so you could cover a lot more ground than you would have back in the UK, they threw a lot of resource at you. At the time they were sending John Glenn back to space at the age of 77 so I had to go off and do a literature review on the physiology of ageing and the physiology of space flight and cross reference that. So, when I walked out of the gate at the end of that month, I thought if I never come back that’ll just be scandalous and I’ve got to find a way to come back. And so I did.

RB: The blue touch paper had been lit, as it were.

KF: It had been lit, and it was a bit weird that it was medicine and not astrophysics that took me to NASA in the end. After that, I would go out there every spare opportunity because I had a security badge by then – that was the important thing. Once you had a badge you had it, and so I would ring up and say “I’ve got a two-month break from my career, I want to come out and do some research with you; I’ll come for free.” And they’d say, “Sure, why not.” Eventually I started winning a few grants, but at the start it was on my own time, in career breaks, which is why it took me so long to become a consultant.

RB: It’s striking: the two poles of your life at that time, this very sleepy GP practice in a village outside Taunton and Johnson Air Force Base: that must have been quite some cognitive dissonance coming back and forth.

KF: It was, I guess. I think I would have been happy with the GP thing, I really do. It’s just this came along and it was irresistible. Literally the first thing I can remember is watching black and white images of the end of the Apollo project: not the landings but the Russians and the Americans in 1975 –

RB: Oh, shaking hands across the –

KF: Yes, I have that image in my head; I know that event happened, that we were taken down to watch that, and it’s just in my head as thinking “Wow this is monumental”. So to get the chance to go back to that, I just couldn’t resist it and all of those feelings that you’d sort of put aside because you thought you were growing up… and it had never really gone away.

RB: But it’s such a wonderful thing to be able to carry that childhood enthusiasm: it’s almost the clichéd example of childhood desire and enthusiasm to want to go into space and to want to go to NASA, and you’ve been able to carry this right through your career.

KF: Oh yeah, I feel enormously lucky. Probably the only two things I thought of as a naive child was I want to be a doctor, I want to be an astronaut; and so I sort of got to do bits of both….

Questions, questions

RB: Now you’re also an anaesthetist – how did the connection with anaesthesia come in?

KF: One of the things about anaesthetics for me was it was one of the areas of medicine where you tried to be reasonably reductionist about the whole thing: “Why am I putting this fluid into this patient’s arm?” “Well it’s because you’re trying to support an intravascular volume and that’s important because of Starling’s Law etc”, and so that was one of the few places for me in medicine where you could find three or four levels of explanation for why you were doing something. Whereas a lot of other places in medicine, it was “Why do we do that?” “Well, because survival benefit is this with this p-value.” “But why?” “Don’t know, actually.”

RB: So you haven’t got a bridge across the chasm; you’ve got a big leap that you have to make across the chasm.

KF: Absolutely, and I found that much more difficult because in physics, the one thing was you could ask questions all the way back. You could say, “Why does the sun shine?” and you could start there: “Oh the sun shines because it’s hot and hot things shine”, or “Why is it hot?” “Well it’s hot because of nuclear fusion.” “Why does nuclear fusion occur?” and you could get all the way back and you could keep going until you got to: “Well, because that’s an axiom and I can’t tell you any more than that.” And you could do that and in medicine it was very rarely the case. So it appealed to that part of me and it appealed to the generalist in me. So I guess that’s what it was. That and the fact that the anaesthetists were much more willing to entertain my slightly bizarre space ambitions. A lot of other specialities wouldn’t have touched it with a barge pole.

RB: What was the leap from all of this into public engagement?

KF: Yes, I’m still slightly amazed that anyone sits up and listens to anything that I give a talk about. I did Grand Rounds: that’s where I first remember doing it. At UCL, I got the opportunity to do Grand Rounds and because they knew I was interested in space and I’d done this elective with NASA, I had to give this very po-faced scientific Grand Round to all of the senior consultants. I was a house officer and it was terrifying. It was in the days of the old slide carousels that would occasionally get jammed and everything. And it went down okay – I had to get a lot of tips on how to do it – and then I gave the same talk somewhere else, because I had the slide set, and it just seemed to go down quite well wherever I gave it, whether it was to other doctors or members of the public. There was something about that tale of exploration, the tale of where the past has got us to and where the future is going to lead us, that was very compelling about the whole human space exploration thing. And then that just led to all sorts of opportunities to communicate and finally led to this, I guess.

Listen to Kevin recount an early experience as a doctor working in television, and one programme idea in particular:

KF: The communication thing has sort of happened by accident. But it is enjoyable, isn’t it, when you know that you’ve done the job well and that people have been – you’ve given them something they didn’t have before or they’ve been engaged in a way that they haven’t been before.

On Monday, the tables will be turned as Kevin interviews Richard about his very different journey from UCL medical school to Wellcome Trust Engagement Fellowship.

Kevin and Richard have guest-curated an event at the Royal Institution on 28 February: ‘From iron lungs to intensive care’ will investigate the history – and future – of intensive care.

Applications are open for the second year of Wellcome Trust Engagement Fellowships. See our website for more details – the closing date for preliminary applications is 30 March 2012.

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The Wellcome Trust is a global charitable foundation dedicated to improving health by supporting bright minds in science, the humanities and social sciences, and public engagement. Read more.

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